Individual provider Active NPI

Gretchen A Voge, MD

  • Neonatal-Perinatal Medicine Physician
  • Maple Grove, MN
National Provider Identifier
1083620306
Registry record updated Nov 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
48694 Issued in MN
Practice address
9875 Hospital Dr
Maple Grove, MN 55369-4648
Phone
(888) 455-2229
NPI assigned
Jul 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 48694 MN
Neonatal-Perinatal Medicine Physician 2080N0001X 48694 MN Primary

Addresses

Primary practice location

9875 Hospital Dr
Maple Grove, MN 55369-4648

Mailing address

9325 Upland LN N Ste 360
Maple Grove, MN 55369-4200
Phone (888) 455-2229

Other practice location 1

3300 Oakdale Ave N
Robbinsdale, MN 55422-2926
Phone (888) 455-2229

Other identifiers 1

IdentifierTypeStateIssuer
656187000MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210427001668 MN Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 0446253991

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
48694MNMDNeonatal-Perinatal Medicine Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636675200000",
    "number": "1083620306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9325 UPLAND LN N STE 360",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553694200",
            "telephone_number": "888-455-2229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9875 HOSPITAL DR",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553694648",
            "telephone_number": "888-455-2229"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3300 Oakdale Ave N",
            "address_purpose": "LOCATION",
            "city": "Robbinsdale",
            "state": "MN",
            "postal_code": "554222926",
            "country_code": "US",
            "telephone_number": "888-455-2229",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VOGE",
        "first_name": "GRETCHEN",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2021-11-12",
        "certification_date": "2021-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "48694",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "MN",
            "license": "48694",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "656187000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maple Grove, MN

Sources for this page

Verify at the official NPI Registry.